Efficacy and safety of aripiprazole in the treatment of delirium

Delirium is a disorder of consciousness and it is caused by acute brain dysfunction in the course of, e.g., severe somatic condition, intoxication or withdrawal syndrome. Delirium management is based on the treatment of the state that caused disturbance in central nervous system. Severe delirium syndromes such as agitation, disorganized behavior or hallucinations require additional pharmacological treatment with antypsychotics. Aripiprazole is used in treatment of schizophrenia, bipolar disorder and Tourette syndrome, but also off-label in delirium. A systematic review of databases was carried out and results were limited to case reports, clinical trials and randomized controlled trials. There is evidence that there is no difference in effectiveness of aripiprazole compared to haloperidol and other atypical neuroleptics. Aripirazole could be a better option in particular groups of patients due to its safer cardiological and metabolic profile as well as better tolerance of treatment. However, data from clinical findings are still insufficient to recommend a routine use of aripiprazole in the treatment of delirium. Therefore, further investigations are necessary to work out new strategy of managing delirium syndrome.